Pain Physicians of Atlanta LLC

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

Legal business name

PAIN PHYSICIANS OF ATLANTA LLC

Practice address

3333 Old Milton Pkwy Ste 400
Alpharetta, GA 30005

Phone

(770) 391-3979

Fax

(770) 391-0020

NPI assigned

Jun 16, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Virginia Minicozzi

Title

Practice Manager

Phone

(770) 391-3979

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ravishanker R Dammanna, MD

  • Anesthesiology Physician
  • Alpharetta, GA
  • NPI 1316052418
  Medicare reassignment Care Compare group NPD
• Kenneth Howard Joel, MD

  • Pain Medicine (Anesthesiology) Physician
  • Alpharetta, GA
  • NPI 1346236411
  Medicare reassignment Care Compare group NPD
• Mohammed Shazad Wada, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Alpharetta, GA
  • NPI 1477785186
  Medicare reassignment Care Compare group NPD
• Mary Gillon Hall

  • Family Nurse Practitioner
  • Atlanta, GA
  • NPI 1063042927
  Medicare reassignment NPD
• Jonathan Tyler Nix, MSN, APRN, FNP-BC

  • Family Nurse Practitioner
  • Alpharetta, GA
  • NPI 1043189095
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1922592641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 OLD MILTON PKWY STE 400",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054437",
            "telephone_number": "770-391-3979",
            "fax_number": "770-391-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 OLD MILTON PKWY STE 400",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "30005",
            "telephone_number": "770-391-3979",
            "fax_number": "770-391-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAIN PHYSICIANS OF ATLANTA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-16",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "MINICOZZI",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "770-391-3979",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208VP0014X",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dorothy Paige, LPC
• Pain & Spine Physicians Surgery Center LLC
• Pain & Wellness Center of North Fulton
• Pain Physicians Anesthesia, LLC
• Pain Physicians of America, LLC
• Carleton A Palmer, PH.D.
• Jessalyn Palmer, NCC, LPC
• Palmercare Chiropractic Alpharetta LLC
• Catherine E. Palmier, M.D.
• Yiming Pan

• Interventional Pain Medicine Physician in Alpharetta, GA
• Providers in Alpharetta, GA by specialty
• Interventional Pain Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.